MEDICARE: ELLEN BRIGHT VAN WART LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	92145	TX

General Provider Information

NPI Number	:	1265395438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN BRIGHT VAN WART LPC

Provider Business Mailing Address
First Line	:	12403 RIP VAN WINKLE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4947
Country	:	US
Telephone Number	:	832-779-7515
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 HIGHWAY 6 S STE 325
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1077
Country	:	US
Telephone Number	:	832-779-7515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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Directions to “ ELLEN BRIGHT VAN WART LPC” Practice Location

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